Healthcare Provider Details

I. General information

NPI: 1710753637
Provider Name (Legal Business Name): JULIET LANDE COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LYELL AVE STE 102
ROCHESTER NY
14606-5743
US

IV. Provider business mailing address

2211 LYELL AVE STE 102
ROCHESTER NY
14606-5743
US

V. Phone/Fax

Practice location:
  • Phone: 585-563-6060
  • Fax: 585-426-4031
Mailing address:
  • Phone: 585-563-6060
  • Fax: 585-426-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: